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The simulation of terrible triad injuries in fresh-frozen human cadaveric specimens with intact soft tissue envelope

INTRODUCTION: The aim of the present study was to develop a technical process to reproducibly generate terrible triad injuries (TTI) in fresh-frozen human cadaveric specimens, while leaving the skin intact. Such “pre-fractured” specimens, used for scientific analysis and for surgical education, migh...

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Autores principales: Lanzerath, Fabian, Knifka, Jutta, Leschinger, Tim, Ott, Nadine, Kahmann, Stephanie, Hackl, Michael, Müller, Lars P., Wegmann, Kilian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10293332/
https://www.ncbi.nlm.nih.gov/pubmed/36512058
http://dx.doi.org/10.1007/s00402-022-04677-x
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author Lanzerath, Fabian
Knifka, Jutta
Leschinger, Tim
Ott, Nadine
Kahmann, Stephanie
Hackl, Michael
Müller, Lars P.
Wegmann, Kilian
author_facet Lanzerath, Fabian
Knifka, Jutta
Leschinger, Tim
Ott, Nadine
Kahmann, Stephanie
Hackl, Michael
Müller, Lars P.
Wegmann, Kilian
author_sort Lanzerath, Fabian
collection PubMed
description INTRODUCTION: The aim of the present study was to develop a technical process to reproducibly generate terrible triad injuries (TTI) in fresh-frozen human cadaveric specimens, while leaving the skin intact. Such “pre-fractured” specimens, used for scientific analysis and for surgical education, might help to improve current treatment, which is complex and prone to complications. MATERIALS AND METHODS: To induce the desired fractures, a custom-made fracturing unit was used to apply an axial force on the extended cadaveric elbow specimens, with the forearm pronated and under valgus load. To simulate the valgus load, a pneumatic cylinder was developed to apply valgus stress to the joint by an additional force vector from the lateral side of the joint. RESULTS: The success rate of TTI induction was 92.3% (12/13). Of the 12 radial head fractures, 3 (25%) were classified Mason type II and 9 (75%) Mason type III. The coronoid fractures were grouped in tip subtype 2 (5 fractures, 41.7%), anteromedial facet (AMF) subtype 2 (4 fractures, 33.3%), AMF subtype 3 (1 fracture, 8.3%) and basal subtype 1 (2 fractures, 16.7%). CONCLUSIONS: The present study provides an instrument for successful and reproducible production of dislocation fracture patterns with their typical accompanying soft tissue lesions. The methodology might be applied on a broad basis to be able to perform biomechanical studies regarding primary stability of fixation concepts for TTI and to educate surgeons in a fairly realistic scenario with the surgical treatment of TTI.
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spelling pubmed-102933322023-06-28 The simulation of terrible triad injuries in fresh-frozen human cadaveric specimens with intact soft tissue envelope Lanzerath, Fabian Knifka, Jutta Leschinger, Tim Ott, Nadine Kahmann, Stephanie Hackl, Michael Müller, Lars P. Wegmann, Kilian Arch Orthop Trauma Surg Trauma Surgery INTRODUCTION: The aim of the present study was to develop a technical process to reproducibly generate terrible triad injuries (TTI) in fresh-frozen human cadaveric specimens, while leaving the skin intact. Such “pre-fractured” specimens, used for scientific analysis and for surgical education, might help to improve current treatment, which is complex and prone to complications. MATERIALS AND METHODS: To induce the desired fractures, a custom-made fracturing unit was used to apply an axial force on the extended cadaveric elbow specimens, with the forearm pronated and under valgus load. To simulate the valgus load, a pneumatic cylinder was developed to apply valgus stress to the joint by an additional force vector from the lateral side of the joint. RESULTS: The success rate of TTI induction was 92.3% (12/13). Of the 12 radial head fractures, 3 (25%) were classified Mason type II and 9 (75%) Mason type III. The coronoid fractures were grouped in tip subtype 2 (5 fractures, 41.7%), anteromedial facet (AMF) subtype 2 (4 fractures, 33.3%), AMF subtype 3 (1 fracture, 8.3%) and basal subtype 1 (2 fractures, 16.7%). CONCLUSIONS: The present study provides an instrument for successful and reproducible production of dislocation fracture patterns with their typical accompanying soft tissue lesions. The methodology might be applied on a broad basis to be able to perform biomechanical studies regarding primary stability of fixation concepts for TTI and to educate surgeons in a fairly realistic scenario with the surgical treatment of TTI. Springer Berlin Heidelberg 2022-12-13 2023 /pmc/articles/PMC10293332/ /pubmed/36512058 http://dx.doi.org/10.1007/s00402-022-04677-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Trauma Surgery
Lanzerath, Fabian
Knifka, Jutta
Leschinger, Tim
Ott, Nadine
Kahmann, Stephanie
Hackl, Michael
Müller, Lars P.
Wegmann, Kilian
The simulation of terrible triad injuries in fresh-frozen human cadaveric specimens with intact soft tissue envelope
title The simulation of terrible triad injuries in fresh-frozen human cadaveric specimens with intact soft tissue envelope
title_full The simulation of terrible triad injuries in fresh-frozen human cadaveric specimens with intact soft tissue envelope
title_fullStr The simulation of terrible triad injuries in fresh-frozen human cadaveric specimens with intact soft tissue envelope
title_full_unstemmed The simulation of terrible triad injuries in fresh-frozen human cadaveric specimens with intact soft tissue envelope
title_short The simulation of terrible triad injuries in fresh-frozen human cadaveric specimens with intact soft tissue envelope
title_sort simulation of terrible triad injuries in fresh-frozen human cadaveric specimens with intact soft tissue envelope
topic Trauma Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10293332/
https://www.ncbi.nlm.nih.gov/pubmed/36512058
http://dx.doi.org/10.1007/s00402-022-04677-x
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